Does Anyone Have a Small (Short) Baby/child?

Updated on February 27, 2009
W.T. asks from Brooklyn, NY
4 answers

Has anyone's LO dealt well, 'smallness'? If so, how did your pediatrician handle it, were you ever referred to an endocrinologists and at what point, and any experience with growth hormone therapy?
My son just turned 1, and he is very small for his age. I am not sure if it is because he is just small genetically (both my husband and I and our families are very petite people) or if it is due to another underlying issue, such as a growth deficiency (both our younger brothers received hormone therapy, but not until they were older, around 10-12 or so). He was growing according to his little curve (between 5-15%) until six months, and though he has grown and gained since then, not as much as expected according to the curve. I thought initially it was because he started day care at six months and got sick a lot, so maybe he was putting his energy into fighting colds and such, but his weight is fine for his height, so it does not appear to be a nutritional issue. He has also nearly tripled his weight (maybe less than a lb shy) which I understand is pretty average expected growth by 12 mths, but he born petite to begin with (6lbs 2 oz). His doctor isn't super concerned yet (nor is the rest of my family including my husband)though I think she wanted to rule things out when he did stop gaining weight during the thick of his non-stop colds, but I can't help but feel it is only a matter of time that we get refered to an endo specialist, esp given our family history. Plus, it is hard not to notice how tiny he is compared to other babies his age. On the other hand, he is developmentally totally on track, is super happy and active. We've already been to a gastro pedi, an ENT, and a pedi genetisist (for reasons unrelated to size) and they have not yet found anything wrong except for the ENT believes he has LPR reflux, though I am told all ENT's seem to think babies have reflux. I am dealing with a ton of anxiety over this, so would love any feedback or advice. I guess I am just trying to mentally prepare myself for a visit to the endo and what to expect. Thanks!

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E.E.

answers from Albany on

I don't think you have anything to worry about at all! My son is 13 months old and not quite 20 lbs, and about 29 in tall. He has always been between the 5 and 15th percentiles for height and weight. Only recently his height went up to 50th, but his weight is still around the 5th. But he is very healthy and does not look skinny at all. And I have always been small- I'm only 5 feet.

It's normal for all kids to not grow as quickly after 6 months. The first few months babies grow at such a rapid weight and then it slows down because of a combination of things- a natural slowing of growth, an increase of movement (crawling, etc) which burns more calories and starting solids because solid foods have less calories than breast milk or formula.
Since you say you and your husband's families are also small, I think this is probably a genetic thing. I think you are wayyyyy over-reacting. Don't bring him to an endocrinologist. That is totally unnecessary at this age. As long as he is hitting all his milestones and the doctor says he is ok, then he is absolutely fine.

You also have to remember that many kids today (even babies) are overweight, so the growth charts are different than in the past. It's actually better to have a child that is a bit lower on the charts than at the top. If you look on an old growth chart from the 70's, when we were kids, I bet your son is in the middle range. My mother-in-law still had my husband's old baby growth chart and our son is growing exactly the same way my husband did, and my husband is 6 feet tall.

But honestly, what's the big deal if he does turn out to be short? I'm short and the biggest problem I have is finding pants that fit- I just get them hemmed. I'm not worried at all, and you should not be either.

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Y.B.

answers from New York on

Been there. My daughter was born tiny - between 5th and 10th percentile - which was not surprising because my husband and I are on the short end of average, grew along that curve for about a year and a half and then dropped off the chart like a rock. Her height-weight ratio was fine -- she was just very little. Here's what the endo will request:

Bone age: an x-ray of the child's left hand to determine skeletal maturity. In small children, it's better if bone age is less than chronological age because that means the child will probably catch up at puberty. Remember that short boy who shot up at age 16 and now towers over the guys who teased him? That's probably a case of delayed bone age.

Blood work: thyroid tests, growth hormomes such as insulin-like growth factor (IGF) 1 and 4 (not sure on the numbers but it's something along those lines). Possibly, blood and urine tests for kidney function.

In my daughter's case, she was producing enough IGF but the medication used to treat an underlying, unrelated endocrine disorder was probably stunting her growth. Fortunately, the condition went dormant and probably will remain so until puberty so the endo weaned her off the meds. As I mentioned before, she was born teeny-weeny to begin with, so the effect of the stunting was frightfully apparent. In addition, the endo prescribed zinc supplements to help the body produce more of its own IGF without need for GH injections. After a year on zinc and off the other meds, she's back on the chart and the doctor expects that she'll return to her original growth curve within the next six to twelve months. Her bone age is way behind her chronological age which is the best news you could have under the circumstances because it indicates that the bones have ample room to grow at puberty.

Don't be surprised that you haven't been referred to a ped endo yet. Babies go through phases. Sometimes a seemingly small baby will catch up by the time he's two, therefore growth issues are generally diagnosed and treated after the child turns three. At least, that what our endo told me.

Relax and enjoy your boy! Keep researching and asking the right questions but don't worry about his possibly having a growth issue just yet. Please feel free to email me.

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A.D.

answers from New York on

Hi W., I understand you are concerned about your baby. If your family is small he may be also. You can consult an endocrinologist and see what he says. My sister's son was seen by one at age 2. It was agreed he was under the charts. They waited until puberty to start the hormone. He is now almost average height and fully developed. Most of all he never felt different than the other kids. He even played football. Love your son but please do not over stress yourself. Grandma Mary

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R.E.

answers from New York on

if you and your hubby are both petite, why do growth hormones. it's in the genes,he just might be on the smaller size. there are people of all sizes out there. i have 2 girls. my 14 yr old is about 5'6" (i'm 5'4" and hubby is just undr 6 ft. tall), and our younger one 9 yrs old is only in the 10 percentile, and it took her years to get ther. we're hoping for at least 5 feet with her. we have some shorter people in our family heritage, and she may have gotten that gene. i wouldn't be crazed...drs are woo quick to get the hormones. you may want to do some research on them yourself before you make any decisions.

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